{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T11:27:14Z","timestamp":1786793234577,"version":"build-2736575974"},"reference-count":62,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100012645","name":"Kentucky Spinal Cord and Head Injury Research Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012645","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Neuroscientist"],"abstract":"<jats:p>Although spina bifida (SB) and tethered cord syndrome (TCS) are often discussed and studied as separate conditions, their co-occurrence is common, clinically consequential, and understudied, particularly with respect to neurogenic bladder and bowel dysfunction. SB arises from incomplete neural tube closure, whereas TCS involves abnormal fixation of the spinal cord, often leading to progressive neurologic deficits. SB affects approximately 3.63 per 10,000 live births in the United States, and TCS occurs in a significant proportion of affected individuals; however, the true incidence of their co-occurrence remains unknown. Current clinical strategies include surgical intervention and symptomatic management, but long-term outcomes are variable, and gaps persist in diagnosis, presentation, and optimal treatment. Bladder and bowel dysfunction are among the most prevalent and functionally impactful complications, yet these outcomes are inconsistently documented and rarely tracked longitudinally. Preclinical models in rodent, porcine, ovine, and feline species provide insight into spinal cord development, tethering mechanisms, and functional consequences, but few examine bladder or bowel function. This review synthesizes clinical and preclinical evidence to characterize overlapping SB and TCS presentations, identifies gaps in bladder and bowel outcome reporting, and highlights opportunities to improve translational animal models and long-term care.<\/jats:p>","DOI":"10.1177\/10738584261470365","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T06:19:27Z","timestamp":1786601967000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Bridging Clinical and Preclinical Perspectives on Spina Bifida and Tethered Cord Syndrome: Presentation, Neurogenic Bowel and Bladder Management, and Animal Models"],"prefix":"10.1177","author":[{"given":"Gabriela X.","family":"Brown","sequence":"first","affiliation":[{"name":"Spinal Cord and Brain Injury Research Center, Department of Physiology, University of Kentucky, College of Medicine, Lexington, KY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8980-108X","authenticated-orcid":false,"given":"John C.","family":"Gensel","sequence":"additional","affiliation":[{"name":"Spinal Cord and Brain Injury Research Center, Department of Physiology, University of Kentucky, College of Medicine, Lexington, KY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/jmg.13.6.511"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10143-024-02959-z"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.30439"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.13548"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.3171\/2008.12.PEDS0874"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11934-017-0684-9"},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/1743-8454-6-S2-S46"},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2015.7"},{"key":"e_1_3_3_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.70338"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.expneurol.2005.03.011"},{"key":"e_1_3_3_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/wdev.215"},{"key":"e_1_3_3_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-008-0780-7"},{"key":"e_1_3_3_14_1","doi-asserted-by":"crossref","unstructured":"Dias MS et al. 2021. Tethered spinal cord among individuals with myelomeningocele: an analysis of the national spina bifida patient registry. J Neurosurg Pediatr. 28(1):21\u201327.","DOI":"10.3171\/2020.12.PEDS20868"},{"key":"e_1_3_3_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/PHM.0000000000000964"},{"key":"e_1_3_3_16_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1980.53.6.0756"},{"key":"e_1_3_3_17_1","doi-asserted-by":"crossref","unstructured":"du Plessis AJ Volpe JJ. 2018. Neural tube development. In: Volpe JJ Inder TE Darras BT de Vries LS du Plessis AJ Neil JJ Perlman JM editors. Volpe\u2019s neurology of the newborn (6th ed.). Elsevier. p. 3\u201333.e38.","DOI":"10.1016\/B978-0-323-42876-7.00001-6"},{"key":"e_1_3_3_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/10790268.2008.11760722"},{"key":"e_1_3_3_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/tera.1420450208"},{"key":"e_1_3_3_20_1","doi-asserted-by":"publisher","DOI":"10.1098\/rspb.1979.0092"},{"issue":"10","key":"e_1_3_3_21_1","article-title":"Tethered cord syndrome after myelomeningocele repair: a literature update","volume":"12","author":"Ferreira Furtado LM","year":"2020","unstructured":"Ferreira Furtado LM, Da Costa Val Filho JA, Dantas F, Moura de Sousa C. 2020. Tethered cord syndrome after myelomeningocele repair: a literature update. Cureus. 12(10):e10949.","journal-title":"Cureus"},{"key":"e_1_3_3_22_1","doi-asserted-by":"publisher","DOI":"10.3233\/PRM-170450"},{"key":"e_1_3_3_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-198907000-00009"},{"key":"e_1_3_3_24_1","doi-asserted-by":"crossref","unstructured":"Gibbons C Coyle D White C Aldridge E Doyle M Cascio S. 2020. Assessment of neurogenic bowel symptoms with the bowel dysfunction score in children with spina bifida: a prospective case-control study. Pediatr Surg Int. 36(7):773\u2013777.","DOI":"10.1007\/s00383-020-04670-8"},{"key":"e_1_3_3_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2006.03.116"},{"key":"e_1_3_3_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20676"},{"key":"e_1_3_3_27_1","doi-asserted-by":"publisher","DOI":"10.3390\/jdb10020022"},{"key":"e_1_3_3_28_1","doi-asserted-by":"publisher","DOI":"10.3171\/2010.3.FOCUS1079"},{"key":"e_1_3_3_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000004013"},{"key":"e_1_3_3_30_1","doi-asserted-by":"publisher","DOI":"10.1159\/000021021"},{"key":"e_1_3_3_31_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep09116"},{"key":"e_1_3_3_32_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2116032"},{"key":"e_1_3_3_33_1","first-page":"205","article-title":"Fetal malformations and maternal alpha-fetoprotein levels in curly tail (ct) mice","volume":"4","author":"Jensen H","year":"1991","unstructured":"Jensen H, Andersen L, Hau J. 1991. Fetal malformations and maternal alpha-fetoprotein levels in curly tail (ct) mice. Int J Fetomaternal Med. 4:205.","journal-title":"Int J Fetomaternal Med"},{"key":"e_1_3_3_34_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.79.1.33"},{"key":"e_1_3_3_35_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1990.73.1.0048"},{"key":"e_1_3_3_36_1","doi-asserted-by":"publisher","DOI":"10.3233\/PRM-190667"},{"issue":"3","key":"e_1_3_3_37_1","first-page":"120","article-title":"A new model for tethered cord syndrome: a biochemical, electrophysiological, and electron microscopic study","volume":"26","author":"Ko\u00e7ak A","year":"1997","unstructured":"Ko\u00e7ak A, Kili\u00e7 A, Nurlu G, Konan A, Kilin\u00e7 K, Cirak B, Colak A. 1997. A new model for tethered cord syndrome: a biochemical, electrophysiological, and electron microscopic study. Pediatr Neurosurg. 26(3):120\u2013126.","journal-title":"Pediatr Neurosurg"},{"key":"e_1_3_3_38_1","doi-asserted-by":"publisher","DOI":"10.1159\/000531750"},{"key":"e_1_3_3_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2025.12.003"},{"key":"e_1_3_3_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdr2.1589"},{"key":"e_1_3_3_41_1","doi-asserted-by":"publisher","DOI":"10.1038\/nm0495-342"},{"issue":"4","key":"e_1_3_3_42_1","first-page":"259","article-title":"Intrauterine treatment of spina bifida: primate model","volume":"39","author":"Michejda M","year":"1984","unstructured":"Michejda M. 1984. Intrauterine treatment of spina bifida: primate model. Z Kinderchir. 39(4):259\u2013261.","journal-title":"Z Kinderchir"},{"key":"e_1_3_3_43_1","doi-asserted-by":"crossref","unstructured":"Mohd-Zin SW Marwan AI Abou Chaar MK Ahmad-Annuar A Abdul-Aziz NM. 2017. Spina bifida: pathogenesis mechanisms and genes in mice and humans. Scientifica (Cairo). 2017:5364827.","DOI":"10.1155\/2017\/5364827"},{"key":"e_1_3_3_44_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10081669"},{"issue":"7","key":"e_1_3_3_45_1","article-title":"The association between urinary continence and quality of life in paediatric patients with spina bifida and tethered cord","volume":"18","author":"Olesen JD","year":"2013","unstructured":"Olesen JD, Kiddoo DA, Metcalfe PD. 2013. The association between urinary continence and quality of life in paediatric patients with spina bifida and tethered cord. Paediatr Child Health. 18(7):e32\u2013e38.","journal-title":"Paediatr Child Health"},{"issue":"9","key":"e_1_3_3_46_1","article-title":"Tethered cord syndrome: role of imaging findings in surgical decision-making","volume":"15","author":"Otto N","year":"2023","unstructured":"Otto N, Kucera J, Hayes LL, Chandra T. 2023. Tethered cord syndrome: role of imaging findings in surgical decision-making. Cureus. 15(9):e44854.","journal-title":"Cureus"},{"key":"e_1_3_3_47_1","article-title":"Congenital spine and spinal cord malformations\u2014pictorial review","volume":"194","author":"Rufener SL","year":"2010","unstructured":"Rufener SL, Ibrahim M, Raybaud CA, Parmar HA. 2010. Congenital spine and spinal cord malformations\u2014pictorial review. AJR Am J Roentgenol. 194(3 Suppl):S26\u2013S37.","journal-title":"AJR Am J Roentgenol"},{"issue":"4","key":"e_1_3_3_48_1","first-page":"306","article-title":"An essay on research into the causation and prevention of spina bifida","volume":"34","author":"Seller MJ","year":"1981","unstructured":"Seller MJ. 1981. An essay on research into the causation and prevention of spina bifida. Z Kinderchir. 34(4):306\u2013314.","journal-title":"Z Kinderchir"},{"key":"e_1_3_3_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/0024-3205(81)90061-8"},{"key":"e_1_3_3_50_1","doi-asserted-by":"publisher","DOI":"10.1098\/rspb.1979.0093"},{"key":"e_1_3_3_51_1","first-page":"206","article-title":"Tethering of the spinal cord in mouse fetuses and neonates with spina bifida","volume":"99","author":"Stiefel D","year":"2003","unstructured":"Stiefel D, Shibata T, Meuli M, Duffy PG, Copp AJ. 2003. Tethering of the spinal cord in mouse fetuses and neonates with spina bifida. J Neurosurg. 99(2 Suppl):206\u2013213.","journal-title":"J Neurosurg"},{"key":"e_1_3_3_52_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semss.2005.02.001"},{"key":"e_1_3_3_53_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1987.66.1.0116"},{"key":"e_1_3_3_54_1","doi-asserted-by":"publisher","DOI":"10.1007\/s002340000325"},{"issue":"3","key":"e_1_3_3_55_1","first-page":"209","article-title":"Patient-reported outcomes of bladder and bowel control in children with spina bifida","volume":"8","author":"Tr\u00e4ff H","year":"2021","unstructured":"Tr\u00e4ff H, B\u00f6rjesson A, Sal\u00f6 M. 2021. Patient-reported outcomes of bladder and bowel control in children with spina bifida. Children (Basel). 8(3):209.","journal-title":"Children (Basel)"},{"key":"e_1_3_3_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1096-7192(02)00108-7"},{"key":"e_1_3_3_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2023.12.012"},{"key":"e_1_3_3_58_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004290100169"},{"issue":"6","key":"e_1_3_3_59_1","first-page":"286","article-title":"Use of the prone position in the MRI evaluation of spinal cord retethering","volume":"25","author":"Vernet O","year":"1996","unstructured":"Vernet O, O\u2019Gorman AM, Farmer JP, McPhillips M, Montes JL. 1996. Use of the prone position in the MRI evaluation of spinal cord retethering. Pediatr Neurosurg. 25(6):286\u2013294.","journal-title":"Pediatr Neurosurg"},{"key":"e_1_3_3_60_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2014.01.027"},{"key":"e_1_3_3_61_1","first-page":"129","article-title":"The conceptualization and development of a patient-reported neurogenic bladder symptom score","volume":"5","author":"Welk B","year":"2013","unstructured":"Welk B, Morrow SA, Madarasz W, Potter P, Sequeira K. 2013. The conceptualization and development of a patient-reported neurogenic bladder symptom score. Res Rep Urol. 5:129\u2013137.","journal-title":"Res Rep Urol"},{"key":"e_1_3_3_62_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2018.02.3101"},{"key":"e_1_3_3_63_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1981.54.4.0494"}],"container-title":["The Neuroscientist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10738584261470365","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10738584261470365","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10738584261470365","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T11:18:06Z","timestamp":1786792686000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10738584261470365"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,12]]},"references-count":62,"alternative-id":["10.1177\/10738584261470365"],"URL":"https:\/\/doi.org\/10.1177\/10738584261470365","relation":{},"ISSN":["1073-8584","1089-4098"],"issn-type":[{"value":"1073-8584","type":"print"},{"value":"1089-4098","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,12]]},"article-number":"10738584261470365"}}